Healthcare Strategies and Planning for Social Inclusion and Development: Volume 1: Health for All - Challenges and Opportunities in Healthcare Management

By Basanta Kumara Behera, Ram Prasad and Shyambhavee Behera

Healthcare Strategies and Planning for Social Inclusion and Development: Volume One: Health for All - Challenges and Opportunities in Healthcare Management examines health care management, particularly in developing countries, along with the key aspects of universal health required to address current global health issues. This new volume begins with an overview of the concept and definition of “Health for All. The book covers how international organizations like the WHO support national health authorities in managing their core healthcare systems, support healthcare workforces, utilize technologies like health information systems, ensure health coverage and funding, and provide primary healthcare education.

This volume is a useful resource to graduate students in public health and health care policy, public health professionals, health and social work researchers, and health policy makers interested in global health and primary healthcare services, particularly in developing countries.

• Covers health issues caused by contagious and non-communicable diseases
• Examines types of funding for control and prevention, along with healthcare treatments for these diseases
• Presents the goal and principles of primary healthcare (PHC) that includes millennium development goals (MDGS), sustainable development for good health (SDGS), and political and economic determinants of healthcare
• Discusses rural healthcare and a framework for rural health management technologies

• Language: English
• Publisher: Academic Press
• Release date: Nov 9, 2021
• ISBN: 9780323904186

Basanta Kumara Behera

From 1978 to 2009, Professor Behera was a Professor of Biotechnology at three distinguished Indian universities, where he taught several postgraduate courses on bio-energy management and biomass processing technology. In 2009 he joined a MNS company as an adviser for speciality chemicals production and drug design through microbial processing technology. Professor Behera is associated with national and international companies as a technical adviser for the production of biopharmaceuticals under cGMP norms. He is an accomplished writer and has authored books published by CRC Press (USA) and Springer Verlag (Germany). Professor Behera's writing takes many forms including free verse, haiku, Senryu, Sonnet, Tanka and quatrain. He publishes English poems in both national and international magazines.

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Chapter 1: Public health and management

Abstract

This chapter explains how hospital community health centers and nurseries home provide preventive curative, rehabilitation care for public health management. In this connection, it is explained how security professions, fire, ambulance providers and emergency medical services can be closely coordinated to increase the efficacy of health services. The authors want to develop awareness among doctors to mobilize other health service processions to manage the system under extreme climatic and disaster conditions to save life and social health stability. The last part of the chapter gives insight on systemic management of disease classification and under what circumstance a disease outbreak becomes epidemic and pandemic at the global level if inadequate management is taken. In this connection, the authors try to explain it with the example of the COVID-19 challenge and bring to the attention of the public to either eradicate or bring stability with the passing of time. So, it is necessary to develop a well-organized health-care system either temporarily or upgrade the existing health-care system to meet the demand in an emergency.

Keywords

Public health; Preventive measures; Communicable disease; Noncommunicable disease; COVID-19; Epidemic; Coronavirus

1.1: Introduction

Public health is a broad term applied to practice to strengthen health services for community well-being under which people can maintain good health, improve their health, or prevent the deterioration of their health. Public health covers the entire spectrum of health and well-being. Public health-care providers are mainly hospitals, physicians, community health centers, and nursing homes that provide preventive, curative, and rehabilitative care. Security professions, fire, ambulance providers, and emergency medical services are closely associated with public health providers.

Public health services function effectively with the collaborative efforts of multidisciplinary teams consisting of doctors, nurses, medical assistants, and many other. Public health management covers the administrative and managerial capacities, organizational structures, and systems needed to finance and deliver health services more efficiently, effectively, and equitably.

1.2: Definition

Public health is the science governing with prevention of disease that is a threat to the overall status of health performance of a community, as well as with prolonging life and promoting health [1]. The main functional aspect of public health is to put organized efforts for the well-being of the community with a healthy lifestyle. Delphi recommends facilitating technique to obtain anonymous acceptance of its suggestion for use in health research and public health development [2,3].

In 1997, Delphi study was able to develop a set of essential public health functions [4], which was at a later stage modified by the Pan America Health Organization and the World Health Organization (WHO) Regional Office for the West Pacific [5]. The Delphi method is a process used to arrive at a group opinion or decision by surveying a panel of experts.

For further adaptation, WHO Regional Office for Europe (WHO, EURO) has developed 10 Essential Public Health Operation (EPHO) [6].

1.3: The history of public health

In the beginning, the public health developers had to confront with some pessimistic people with vested interest, who used to discourage the public health services procedural follow-up by quoting some unusual social ethics. Opposition to Jennerian vaccination, unnecessary criticism of the work of great pioneers in public health measures such as Louis Pasteur, Florence Nightingale, and many others had unnecessarily delayed the innovative breakthrough in preventing diseases.

Jenner’s vaccination is the most interesting factual story on public health services. The Egyptian mummies from the 18th and 20th Egyptian Dynasties (1570–1085 BC) having small lesions resembling those of smallpox was the first evidence of smallpox existing. But it is believed that smallpox first appeared around 10,000 BC, at the time of the first agriculture settlements in Northeastern Africa. European states were victimized sometime between the fifth and 6th centuries and later were brought to the New World by Spanish and Portuguese conquistadors, where it decimated the native populations. Smallpox is mainly caused by exposure to the Variola virus and infection typically begins like a common cold.

Although opposition to Jenner’s vaccination continued till the late 19th century in some areas, its supporters gradually gained ascendancy, ultimately leading to the global eradication of smallpox.

In 1861, Louis Pasteur published germ theory which proved that bacteria caused diseases. This idea was taken up by Robert Koch in Germany, who began to isolate the specific bacteria that caused particular diseases, such as TB and cholera. Louis Pasteur’s germ theory was discarded at the initial stage. People disapproved Louis Pasteur’s model of infectious diseases and argued that Antoine Bechamp’s theory was right [7]. Another observation was that the diseased tissues attract germs rather than being caused by them [8]. This was also a contradicted statement against germ theory developed by Louis Pasteur.

In 1881, Louis Pasteur developed a vaccine for anthrax, which was used successfully in sheep, goats, and cows. In 1885, while doing research on rabies, Pasteur tested his first human vaccine. This vaccine was developed by attenuating the virus in rabbits and subsequently harvesting it in their spinal cord. After his great success in developing, rabies vaccine for humans Pasteur was able to conclude that if a vaccine could be found for smallpox, vaccines could also be found for all diseases. In 1878, Pasteur successfully cultured the bacteria responsible for causing chicken cholera and began inoculating chickens (Fig. 1.1).

Fig. 1.1

Fig. 1.1 Pasteur’s fowl cholera experiment. Birds inoculated with an aged culture of Pasteurella multocida did not die. However, when subsequently inoculated with a fresh culture of virulent P. multocida, the birds were found to be protected. It was this experiment that launched the science of immunology.

But during such a trial many chickens died. So, at a later phase, he emphasized on safe inoculation methods in order to avoid chicken death during inoculation. The incidental story on the chicken cholera vaccine was quite interesting. In 1879, Pasteur noticed that old bacterial cultures were lacking the virulence. Incidentally, Pasteur gave instructions to laboratory assistance to inoculate fresh culture of the viral bacteria before leaving for holiday. Unfortunately, the laboratory assistant forgot to inoculate the chicken with fresh bacterial culture. After returning from 1 month holiday, he performed the same job by inoculating old culture to the chicken and surprisingly could notice only mild signs of diseases and chickens survived. At a later phase when the chicken was healthy, Pasteur inoculated the healthy chicken with fresh bacterial inoculums and surprisingly noticed the chicken with good health. Pasteur came to conclusion that by exposing to ambient atmospheric oxygen condition lost their virulence potential. The discovery of the chicken cholera vaccine by Louis Pasteur revolutionized work in infectious diseases and can be considered the birth of immunology.

The conceptual development of public health-care approaches can be well explained under the following heads.

1.3.1: Public health care and social ethics

Epidemics such as plague, cholera, and smallpox were dominated before the 18th century. Under the cloud of social ethics and inheritance of mythological believes people depend on God’s blessing to prevent and cure diseases. People believed in a healthy deity (god or goddess) in mythology or religion associated with health, healing, and well-being, and also related to childbirth or mother goddesses (Fig. 1.2).

Fig. 1.2

Fig. 1.2 People worship energy goddess for curing CORONA-19 (South China, India).

Epidemic diseases were used as signs of poor moral and spiritual conditions, to be governed through prayer and piety (Fig. 1.3). Some pandemic epidemic was monitored through isolation of ill and quarantine of travelers. In the late 17th century, several European cities appointed public authorities to adopt and enforce isolation and quarantine measures [9].

Fig. 1.3

Fig. 1.3 Mass prayer for COVID-19 performed in different countries.

1.3.2: Restriction in public movement

The practice of isolation of ill, and quarantine of travelers before entering new countries were noticed to be a common measure for the prevention of pandemic contagious diseases. In 1701, Massachusetts passed the law for quarantine for traders and isolation of sick suffering from smallpox. By the end of 18th century, several cities like Boston, Philadelphia, New York, and Baltimore had well-framed quarantine and isolation rules as prevention measures against pandemic diseases [10].

During this period most of the developed cities established voluntary general hospitals for the physically ill and public institutions for the care of the mentally ill. Even the government made an official rule to take care of the physically and mentally ill by the neighbors in local communities [11,12].

By the end of the 18th century, several communities started demanding better formal arrangements for the care of their ill than Poor Law practices. The first American voluntary hospital was established in 1752 and in New York in 1771. The first public mental hospital was established in Williamsburg, Virginia in 1773 [13].

1.3.3: Sanitization awareness and public health care

Public awareness on sanitization intensified at the beginning of 19th century as an indicator of poor social and environmental conditions, and as well as for social and spiritual conditions.

In the 19th century, during the Victorian Era, the health and sanitization conditions were not to the mark. Tuberculosis, smallpox, measles-like bacteria/virus contamination in London was common. This was mainly due to horse transportation and cesspools filled the street with feces, and virus contamination was unavoidable (Fig. 1.4).

Fig. 1.4

Fig. 1.4 London roads were dumped with horse’s wastes (during 1800s). Near Regent street used to have 1000 horses for transport system.

In the 19th century, horses were walking all day on the street, making the street road dirty and unhygienic with feces. The government employed young boys to clean the street road covered with feces from horses. But no improvement was noticed and the London Street was extremely unhygienic with horse feces. In Victorian era, every home used to have a cesspool (Fig. 1.5).

Fig. 1.5

Fig. 1.5 Georgian Era Toilets (Toilets in victorian-era.org ).

The only known place with toilets was called the Crystal Palace. Basically, cesspool was just deep holes that people would go to the bathroom in. Over time, the cesspool would fill up, and night workers would go around and empty them. It was illegal to empty the cesspool in the daytime due to an extremely foul smell. Some villagers would dump buckets of feces onto the sidewalk in the middle of the day which was another huge sanitary issue. In 1750, the population of Europe increased rapidly, with the simultaneous increase in infant death growth rate. These unfortunate incidents led to the rapid development of voluntary hospitals in the United Kingdom. The people’s efforts had drawn the attention of the government to initiate precaution measures and extend public health facilities. In 1752, British physician Sir Johan Pringle published a book that explained ventilation in barracks and the provision of latrines.

In a developing country like India, sanitization has been a priority since ancient time, as scripted in Vedic times. The remnants of Indus Valley showed the awareness of people for public hygiene (Fig. 1.6).